"But I would say that doctors should certainly monitor their patients on ADT for changes in bone mineral density, and, if they see a decrease, then they should consider some preventive therapies," he advised. "They should also be vigilant for abnormal lipo [blood fat] profiles, in terms of cholesterol levels and serum levels of insulin, which are markers for both cardiovascular and skeletal fracture."
He said that doctors could prescribe statin drugs to help lower cholesterol, while encouraging lifestyle changes to improve diet and physical activity.
Dr. Nelson Neal Stone, a clinical professor of urology and radiation oncology at the Mount Sinai School of Medicine in New York City, said that the findings "reinforce what we already know".
"It's been well known for a while that ADT boosts a patient's risk for fracture, just like it happens among women who go on anti-estrogen therapy for breast cancer," Stone noted. "And there have been several studies published in the last three to five years that find that men who go on the therapy are at an increased risk for all sorts of cardiovascular issues."
"While we all know that this therapy is needed to prevent the progression of metastases, it is true that while you are preventing a serious event on the one hand you are potentially putting the patient at risk," Stone said.
"So the bottom-line is that we have to be careful about who we put on ADT," he said. And research into preventive techniques needs to continue, he said, "because the therapy obviously entails some potentially severe side effects."
The American Cancer Society has more on prostate cancer.
SOURCES: Lockwood Taylor, M.P.H., doctoral candidate, divis
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